Individual
KATRINA L PORTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LSCSW
Contact information
Practice address
900 MASSACHUSETTS ST, SUITE #408, LAWRENCE, KS 66044-2868
(785) 220-5690
(785) 864-0014
Mailing address
900 MASSACHUSETTS ST, SUITE #408, LAWRENCE, KS 66044-2868
(785) 220-5690
(785) 864-0014
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
3622
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200631120A
—
KS
01
—
P00655165
RR MEDICARE
KS
Enumeration date
08/30/2006
Last updated
08/06/2013
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